GPs and academics attending a Future Trends Round Table at the King's Fund in December unanimously agreed it would be very difficult to implement telehealth at scale without fully integrated services.

"Based on our experience from the DH's Whole System's Demonstrator (WSD) trial, telehealth must be fully integrated into a patient's care pathway," said Dr Shah, GP Lead at Newham Health Partnership.

"Patients and their families must also be on board, and this takes time.

"We found that improved quality of life for patients and cost benefits to the commissioning group emerged after approximately six months."

The warning has coincided with the launch of the government's 'Three Million Lives' campaign, in which it has committed to make the use of telehealth and telecare programmes more widespread across England over the next five years.

It is claimed the campaign could lead to a potential net efficiency gain of around £1.2bn over the next five years.

"The trials of telehealth and telecare have shown how people with long term conditions can live more independently, reducing the time they have to spend in hospital and improving their quality of life," said Care Services Minister Paul Burstow.

"I want to see more people across the country benefit from this sort of technology."

There are currently around 5,000 telehealth users and 1.5 million pieces of telecare in use in England.

Your comments (terms and conditions apply):

"Yes I do - my company has been part of the IT delivery for two telehealth trials: in care homes (Sheffield and Bradford) and with patients with a chronic skin condition called Epidermolysis bellosa (Kings College London). Both trials showed it is possible to generate improved health outcomes for patients to remain at home or away from hospital, whilst still being in contact by having patient recorded outcomes routed electronically to acute care specialists. We need much more support to take these trials to wider projects. In particular we need buy-in from those who control the current IT infrastructure. For example many GPs use software to record patient notes. These large scale IT providers are very reluctant to accept data feeds from other systems supplied by small companies like ours, not for reasons of security or patient confidentiality but because to do so would not be to their commercial advantage. This has an affect when pilot telehealth projects attempt to go to scale - at this point connectivity of data becomes a requirement. But companies like EMIS and CSC resist entirely reasonable requests fordata integration." -

The NHS is to expand the use of telehealth, allowing doctors to remotely monitor patients with long-term conditions.

The government's Care Services minister Paul Burstow said telehealth and telecare, which employ electronic equipment in homes to read key health signs, would be extended over the next five years to reach three million people.

The key thing is that both systems can be accessed by doctors in other locations. “I want to see more people across the country benefit from this sort of technology,” Burstow said.

Telehealth equipment reads signs such as pulse, weight, respiration and blood oxygen levels, while telecare refers to the sorts of devices – like personal pendant alarms worn around the neck or bed sensors to detect unexpected movements – which can help patients with, say, dementia to avoid unplanned admissions.

Burstow’s new focus on this reflects a trend in public health thinking over the last decade which has increasingly seen treating people at home as desirable.

There are potential health benefits for users – plus a possible £1.2 billion net efficiency gain over the next five years for a government faced with tough spending decisions.

There is some way to go before this is possible, however: to date, there are only around 5,000 telehealth users and 1.5 million pieces of telecare in use in England.

But the need is very apparent: currently 15.4 million in the country have at least one condition which can be managed but not cured, rising to a projected figure of 18 million over the next 20 years.

The government suggests that trials over the last three years involving 6,000 patients and more than 200 GP practices in Cornwall, Kent and Newham have shown people can reduce the time they have to spend in hospital and improve their quality of life.

If these figures are extrapolated this could be highly significant, since the patients at which the technology is aimed use around 75% of all inpatient bed days, 65% of outpatient appointments and 55% of all GP appointments.

In total, they account for around 70% of the total health and social care spend, the government says.

Discussion over the top 5 top medical apps of 2011 named by Apple's editorial staff, with a description of each and links to iTunes...

Apple, like many companies, has produced a list of its top apps in many categories found in iTunes called Apple Rewind 2011.

While the criteria for picking the winners is probably loosely based on the amount of downloads and the overall popularity, the picks are still solely chosen by Apple’s editorial staff, and thus there is probably an element of bias in the choices. You might remember the criticism we levied at Apple recently about their “Apps for Healthcare Section” — a section in iTunes that made an attempt at categorizing the medical category. Although we personally wouldn’t rank these apps as the top 5, they do list some great medical apps.

Today we will look at the five winners based on Apple in the medical category. We have provided the iTunes links at the end of the article. Not surprisingly, some of the winners in the medical category are FDA approved apps, and we’ve done extensive commentary and reviews on all the apps mentioned.

There has been a great deal of discussion lately about regulation stifling innovation in the medical device sector. Much of it strikes me as misguided or a discussion of something unrelated. Instead, it is my opinion that efforts to avoid regulation are an important contributor to stifling innovation of safe and effective medical devices. Let’s begin by defining our terms:

1. Invention is the act of creating, or improving, something that is new.2. Innovation is the act of successfully commercializing something that has been invented; it will be successful, if it has real (utilitarian) or perceived (aesthetic) value. This definition is consistent with the over half century of published work on diffusion of innovation. Innovation cannot include commercializing dangerous or defective products. If you want to protect your profitability, make sure your products are safe (each won’t cause harm) and effective (each will do what you claim).3. Regulation (in the medical device sector) is a control mechanism for protecting the public (health).

Yes, regulation can impact invention. If there is little or no opportunity to benefit from your intellectual property, then it is likely that you will focus your energies elsewhere. Regulation can also impact innovation; in fact, that is exactly FDA’s congressionally-mandated mission. Congress established that FDA regulates manufacturers—not inventors, practitioners, or consumers. Practitioners are regulated by each individual state. Congress charged FDA with protecting the health of consumers.

When New York-based Akshay (name changed) came down to visit his grandparents in Mumbai, his iPad was one of the most important possessions in the luggage. Diagnosed with autism since he was 18 months of age, the 10-year-old who speaks only a few words managed to communicate with his grandparents and visitors with the “magic tablet”.When hunger pangs struck, for instance, the boy would move his fingers across the iPad’s touchscreen to scroll down to the picture of a dosa. A words-free message had successfully been communicated. The iPad is, in fact, emerging as the wonder tool for autistic children across the world. No wonder then, Mumbai’s parents and children too have slowly taken to the tablet. Last fortnight, the Forum for Autism held a special workshop on iPad’s many uses for special children at Umeed resource centre near Chinchpokli.

“The touchscreen makes it so much easier for our children as opposed to a keyboard or a mouse,” said Chitra Iyer, who recently bought an iPad for her son.

Incidentally, the World Wide Web has a wealth of sites dedicated to parents of special children on how to use the iPad effectively. The iTutorial not only provides parents with easy-to-use ways but also grades various applications. “There are over 350 applications suitable for people with autism, and in general for people with special needs, classified into 14 categories,” the website reads.

One of the applications, named Proloquo2go, provides a way for autistic children to communicate their desires and feelings. Another called Math Bingo is used to teach mathematics; the goal of this game is to choose the right answer for the sum and complete a continuous line in order to get bingo. Internet reviews said the site is useful to teach subtraction, addition, multiplication and division.

“One no longer needs to make or buy flashcards to teach words and emotions to their children. The iPad has it all,” said a parent who attended the Mumbai workshop.

Autism

Difficulty mastering certain academic skills can stem from pervasive developmental disorders such as autism and Asperger’s syndrome. Children with autism spectrum disorders may have trouble communicating, reading body language, learning basic skills, making friends, and making eye contact.

A new World Congress forum coming to Boston in March will systematically pair eHealth and mHealth entrepreneurs with health care providers and payors in order to accelerate the adoption of promising new innovations and build upon a burgeoning...

As mHealth continues to grow, innovative ways are being explored to heighten its seemingly limitless potential. Central to that promise is the idea of facilitating and stimulating physician and patient engagement, a goal already analogously realised with phenomenal success in the gaming industry.So let’s define ‘gamification’ and describe how it has already made a significant impact on healthcare, and then provide a few examples of gamification of mHealth and what they augur for a very bright future.Why are games relevant and what is ‘gamification’?Marketing and communications experts have historically focussed on maximizing their ability to share information with a relevant audience in order to induce some form of behavioural change.The advent of digital technology has transformed passive receptivity into active, highly targeted two-way conversations, creating dynamic opportunities for qualified engagement that carry well beyond the immediate exposure to the messaging.“The advent of digital technology has transformed passive receptivity into active, highly targeted two-way conversations…”Always looking to measure and optimise their capacity for engagement, professionals have been astonished by the success of the gaming industry to capture the attention and stimulate the involvement of billions of people from every demographic across the planet.

AirStrip Technologies has received European CE Mark certification for its mobile patient monitoring applications. The apps provide mobile access to vital live and historical patient data including waveforms, ECGs and other information and it received FDA clearance last August. Applications currently available include AirStrip OB, AirStrip Cardiology and AirStrip Patient Monitoring. AirStrip Cardiology was recently featured as the best US medical application for the iPhone as part of Apple’s App Store Rewind 2011.

It’s been a long wait, but the FDA finally delivered. They’ve come through with at least some direction for how pharma companies can properly use social media. It’s not a complete answer to every issue, but it is a good start. I’ve reviewed the full contents of the guidance that the FDA released on December 30, 2011 and found it, not surprisingly, a bit hard to follow at times

Telehealth will lower cost and widen the reach of clinicians and will become a major differentiator for hospitals this year. Busy, tech savvy patients want more access to healthcare and as providers we have to go where our patients already are … at home!

According to American Hospitals Association 70% of the “most wired” hospitals in America already provide telehealth.

Leading this new strategy is England, where the National Health Service [NHS] has implemented a telehealth project, entitled “3 Million Lives”, by installing remote patient monitoring systems in patients homes.

A previous pilot study conducted by the NHS reviewed over 6,000 patients in three cities suffering from three primary conditions, diabetes, heart failure or COPD. The results we powerful …

Remote monitoring reduced mortality rates by 45%

Related data was also encouraging …

emergency visited were reduced by 15%,emergency admissions were reduced by 20%bed days was reduced by 14%and total costs per patient was reduced by 8%.

"In the future we might not prescribe drugs all the time, we might prescribe apps." Singularity University's executive director of FutureMed Daniel Kraft M.D. sat down with me to discuss the biggest emerging trends in HealthTech.

Teaching hospitals the world over face increasing difficulties in sourcing real patients who exhibit every conceivable ailment which medical students need to learn to diagnose and treat. An e-learning approach using interactive computer simulations known as virtual patients is one way to solve the problem, but in which settings is the use of these virtual patients most effective? Engineer and lecturer Martin Riemer and his co-author Martin Abendroth, a medical doctor, have spent the past year studying the use of virtual patients by hundreds of students at the University Medical Centre Hamburg-Eppendorf, Germany, and their findings shed light on how best virtual patients should be integrated into the curriculum.

Michael Porter is a Principal at Perficient for Portal, Social, and Collaboration solutions. He leverages 13 years of experience with portal and content management projects to help clients understand and take advantage of the value provided by web technologies. He has supported many multi-million dollar portal implementations for some of the world’s largest companies. Michael supports Perficient’s sales and marketing organizations through the creation of industry-leading services that help clients understand their enterprise portal and has helped to position Perficient as one of the top providers of strategic portal solutions. He regularly speaks at industry and partner events on portal and social topics.Check out his blog at: http://blogs.perficient.com/portalsFollow Mike on Twitter @PorterOnPortal What are the best ways that healthcare organizations can use portal technology to engage with patients and members?

With all of the unstructured data in medical journals, doctors' notes, radiology images and faxes, IT vendors have been developing technology to help the health care industry make sense of all the loose data.

In 2012, vendors will continue to develop cloud databases and supercomputers such as IBM Watson to store and process large volumes of "big data" and allow doctors to use this information to personalize medical treatment, according to experts.

"We really see big data as the new frontier across all industries, specifically health care," Richard Cramer, chief health care strategist at data integration vendor Informatica, told eWEEK. "The next decade is going to be the data decade in health care."

Past and current data could bring clinical and financial risk to light and allow physicians to find the best treatment options, said Michael Lake, health care technology strategist and president of research firm Circle Square.

"Big data, clinical analytics and personalized health will be huge in 2012," Lake predicted in a statement.

"From our perspective there's a huge potential in combining large-scale computing resources with this wealth of data to run big science—we're definitely seeing that trend," said Jason Stowe, CEO of Cycle Computing, which develops utility supercomputers that enable life science researchers to analyze large amounts of data in a short period of time. "There's a lot more data generated that people want to analyze, and this is going to continue into 2012."

Personalized medicine provides physicians with a comprehensive understanding of a person's health and genomic makeup, rather than relying on a superficial understanding of other patients' histories.

"You need sophisticated data management and you need the ability to analyze all the digital chemistry that goes on in a single patient," said Shah.

Traditional IT vendors such as Dell and Hitachi Data Systems are moving forward with ways to store big data for verticals such as health care, he noted.

"Instead of one size fits all, let's find the right size for you based on who you are, and that's really the goal of personalized medicine," Dr. David Zirl, area vice president at Dell Healthcare and Life Sciences, told eWEEK.

Finding the right drug based on the right data is called pharmacogenomics, Zirl noted.

On Nov. 10, Dell announced that it will donate its cloud infrastructure to a company called Translational Genomics Research Institute (TGen), which will store data for trials of potential pediatric cancer medication.

With the cloud and supercomputers, IT will play a critical role in being able to speed up the time for data to be analyzed, Zirl noted. The speed of data analysis is critical when dealing with patients who may not have more than a month or two to live, he said.

"Speeding up treatment ultimately leads to better quality of care being delivered, and we believe that's a big aspect of what's coming this year and beyond," said Zirl.

SummaryGlobalData's new report, "India Diabetes Care Devices Market Outlook to 2017- Glucose Monitoring and Insulin Delivery" provides key market data on the India Diabetes Care Devices market. The report provides value (USD million), volume (units) and average price (USD) data for each segment and sub-segment within two market categories – Glucose Monitoring and Insulin Delivery. The report also provides company shares and distribution shares data for each of the aforementioned market categories. The report is supplemented with global corporate-level profiles of the key market participants with information on company financials and pipeline products, wherever available.This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GlobalData's team of industry experts.

The path to fixing the health-care system in the United States could lead straight through your cell phone.

The federal government may be on the way to a successful hacking of health-care, and the path may lead straight through your cell phone.

On Dec. 6, the federal government launched the month-long Healthy Apps challenge to encourage the creation of new mobile applications that can help people make healthy lifestyle choices. By shifting the health-care debate to the level of the mobile device and encouraging people to think in terms of lightweight apps instead of massive spending programs, U.S. Surgeon General Regina Benjamin is helping to shrink the scope of the seemingly intractable health-care debate facing the country.

If the Healthy Apps challenge can start to generate the same kind of excitement and success as other hackathons and prize competitions in the private sector, it might show that it’s possible for the U.S. government to hack health care.

After all, so many of the massive health-care solutions the federal government tends to create, such as “ObamaCare” (as it is known by those on the ideological right), are so large and complex that they inevitably run afoul of partisan debate.

But what happens when you gamify the health-care equation or when thinking big means thinking small? The winning selections from the Healthy Apps challenge will not just be those that solve an important health problem using data — they will be the solutions that, according to Benjamin, integrate a “fun factor,” are tailored to the needs of people who are not “high tech” or early adopters and, to top it all off, Benjamin will personally test-drive the winning solutions.That’s where things get interesting, because Benjamin has been at the forefront of finding solutions to under-resourced, under-served populations for years. Before she became Surgeon General, she was the founder of a rural health clinic in Alabama and rose to prominence for her leadership skills in the South in the aftermath of Hurricane Katrina.

Oh, and did I point out that she was a winner of the MacArthur “genius” grant award in 2008?

The reason why mobile health is one of the fastest-growing segments of the global health care industry is that it is the perfect fit for under-funded, hard-to-reach populations. People who do not have computers still have mobile phones. As a result, some predict that the mobile health industry could grow even faster over the coming decade, to become a multi-billion-dollar market opportunity. Mobile health has already skyrocketed to prominence in the emerging markets. Now that people are relying more so on their mobile phones, it makes sense to turn to mobile health solutions in developed markets as well.

Think about some of the fun developments that are starting to come out of the mobile health field. The new Jawbone UP — a Wi-Fi enabled bracelet that syncs with an iPhone app to help you develop a healthier lifestyle is a popular choice on many year-end holiday gift lists. It is also the type of innovation that could emerge out of future mobile health competitions. Healthy apps are starting to become a mini cottage industry, with Trendhunter recently highlighting 20 of the most important new healthy apps that claim to do everything from being your personal trainer to measuring happiness. In 2012, mobile apps will likely become an even more important part of the mobile health-care revolution.

What remains to be seen, however, is whether the same energy and innovation that has emerged at large prize competitions like the federal government’s DARPA challenges can be transferred to the much slower-moving health-care field. Nevertheless, the Healthy Apps challenge is an important first step to re-framing the debate over health care. By turning to mobile health solutions and prize competitions that favor grassroots innovation, the U.S. federal government might just be able to crack the colossal health-care innovation challenge. Solving the nation’s health-care problems? It appears there may soon be an app for that.

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